ESPM Final Study Guide

Vocabulary-style flashcards covering the key concepts and definitions of environmental health policy, risk categories, and risk transition frameworks.

Value Triad

A framework where political struggles are shaped by the interactions between three key values: economic, equity, and the environment.

Trans-science issues

Issues that lie at the interface of science and politics which transcend the proficiency of science to answer, often involving political, economic, or moral dimensions.

Type 1 Diseases

Traditional diseases including communicable and infectious diseases, maternal mortality, and nutritional diseases.

Type 2 Diseases

Modern diseases including non-communicable diseases, cancer, heart and lung diseases, neuropsychiatric conditions, and congenital defects.

Type 3 Diseases

Non-transitional diseases consisting of injuries, subdivided into unintentional (e.g., agriculture, motor vehicle, falls) and intentional (e.g., suicide, violence, war).

Local Traditional Risks

Risks occurring at the household level, such as traditional diseases, sanitation, water, and food safety.

Community Transitional Risks

Risks at the community level, including urban air quality and occupational hazards.

Global Modern Risks

Modern risks on a global scale, such as cancer and heart disease.

Risk Overlap

The phenomenon where traditional risks are declining while new risks are simultaneously increasing.

Risk Genesis

The creation of entirely new types of risks.

Risk Transfer

Occurs when efforts to reduce one type of risk result in making another type of risk worse.

Risk Synergism

A situation where the combined risk associated with two or more factors is greater than the sum of their solitary effects.

Factors affecting (re) emergence of infectious diseases

ecological changes, human behavior and demographics, international travel, technology, microbial adaptation, breakdown in PH infrastructure

Environmental burden of disease

Disease burden attributable to environmental factors impacting susceptibility to and recovery from disease/injury

Attributable risk

amount of disease that would not exist today if exposure to a specified risk factor that causes that disease had not occurred

DALY

YLL + YLD

What is DALY?

Metric of mortality and morbidity that outputs a present value of future years of disability free life that are lost as result of the premature deaths or cases of disability occurring in a particular year

Critiques of DALY

Deaths of individuals who are old, sick or disabled contribute less to estimated burden of disease, doesn’t account for resource allocation, and lack of consistent and quality data

Global Burden of Disease Study

Measures burden of disease globally which helps set health research priorities, identify vulnerable groups, target health interventions and guide programs

Health Equity

Everyone has a fair and just opportunity to be as healthy as possible. Reducing disparities in health and its determinants.

GINI Coefficient

A/A+B with values ranging from 0-1

What is Gini a measure of?

Measure of income or wealth inequality

What does a low gini score mean?

More equitable distribution but 0 meaning perfect income equality

What does a high gini score mean?

Less equitable distribution with gini of 1 meaning perfect income inequality

Lorenz Curve

Graphical representation of income inequality

Absolute Income Hypothesis

Consumption will rise as income rises but not at the same rate

Relative Income Hypothesis

Saving and spending behavior is affected by a person’s relative position in the income distribution with lower savings rates in more unequal societies

Materialist Approach

Health effects are driven exclusively by access to tangible resources such as food, clothing, shelter and ability to control life

Psychosocial Approach

Health effects are mediated through symbolic resources such as status, prestige and control

Racial segregation and environmental quality in US cities

Air quality is worse for POC and it’s worse in more segregated cities

Wealth/income distribution and health outcomes

Linkages b/w equity and environmental quality

More unequal societies have more polluted and degraded environments.

Inequality/Sustainability Hypothesis

Social inequality is linked to poor environmental quality in the literature through asymmetries in political power, environmental intensity of consumption and level of social cohesion and cooperation

Contextual effect

Inequality has spillover effect on pop health above and beyond direct impacts of impoverishment on health of poor

Social gradients of health

Linking of inequality and health with how individually oriented preventative action can push health hazards

Examples of social gradients of health

Occupational status, unemployment, poor housing

The Whitehall Studies

British civil servants at every occupational grade lived longer than their inferiors in the british civil service hierarchy

The Great Gatsy Curve

Documents empirical relationship b/w income inequality and intergenerational earning elasticity

Inequality, trust and cooperation

Inequality leads to more rivalry and fear of others

Achieving equity through policy

Improving access to the conditions and resources that strongly influence health for those who lack access and have worse health with policies oriented toward equity

What is equity oriented policy?

Soften impact of inequality by improving conditions of daily life, narrow the gap by addressing inequitable distributions and track progress

Significance of chemicals in 1st industrial revolution

Mass production of energy materials and machinery driving up productivity and volume of production

Significance of chemicals in 2nd industrial revolution

Chemical manufacturing, use of petrochemicals and electricity marking expansion yields and use of chemicals

Significance of chemicals in post-war American: the age of mass consumption

American military and economic hegemony with high rates of consumers, increased government spending for public programs, suburbanization and rise in petrochemical industry

Chemical Ignorance

Chemicals entering marketplace without comprehensive and standardized information on their reproductive or other chronic toxicities

Toxic Substances Control Act 1976

Federal regulatory framework for chemical regulation

Weaknesses of TOSCA

Ineffective, grandfathered in legacy chemicals, put burden of proof on EPA, cost benefit analysis over risk analysis, industry influenced and limited resources for risk assessment

Frank Lautenberg Chemical Safety Act 2016

Amendment of TOSCA with review and regulation of chemicals to be focused on health risk and costs

Strengths of Frank Lautenberg Chemical Safety Act 2016

Removed requirement that EPA choose least burdensome regulatory option, established science standards and risk evaluation process, review of chemicals already in use, EPA must evaluate entire lifecycle of new and existing chemicals

Environmental Public Health Continuum

Sources, emissions, concentration, exposure/dose and health effect

Sources

Where environmental chemicals come from

Examples of sources

Smokestacks, car emissions, dry cleaner, household products

Emissions

Release of chemicals into the environment

Characteristics of emissions

Toxicity, mass, volume, solubility, and attributes the give idea of potential health effects of a pollutant

Concentration

Measures and concentration of pollutant in various medias

Measuring concentrations of env chemicals in:

Air, water, soil and fod

Concentration of pollutants and their transport

Through environmental pathways and chemical transformation due to sunlight exposure

Exposure

Indicates degree to which chemical reaches the barriers b/w individual humans and their environment

Exposure in population

Function not only of concentration but of how many people are in contact for how long

Pathways of exposure

Inhalation, ingestion, absorption

Dose

Measure of amount of material that has penetrated into the body or into critical organs of the body

Health effects

Adverse health outcomes from exposure

Fate and transport of environmental contaminants

Route of emissions spreading health effects of pollutants

Endocrine Disrupting Chemicals (EDCs)

Increase/decrease hormone production, mimic and change hormones, interfere with cell signaling, cause premature cell death and prevent proper gene functioning

BPA

Used to form polycarbonate plastic and epoxy and used in can linings

Exposure Routes for BPA

Dietary ingestion, workplace exposure, water pipe epoxy, fetal and early childhood, hydrolysis, bioaccumulation and chronic low level exposure

Health Effects of BPA

EDC, infertility, reduced sperm count, brain development, prostate and breast cancer, early onset female puberty, diabetes and obesity

Bisphenol S (BPS)

Chemical found in many BPA free consumer products which is just as potent in altering brain development and causing hyperactive behavior

Phthalates are found

Everywhere, in medical devices, personal care products, toys, food wrap and more

Health effects linked to phthalates

Endocrine disruption, male reproductive health effects, reduced fertility, learning and behavior effects, obesity, diabetes and rise in chronic diseases

Triclosan

Antibacterial pesticide used in countertops, soaps, toothpaste and cleaning products that can alter thyroid hormonse critical to proper brain development and cvd health

Is triclosan banned?

Yes it’s banned from anti-bacterial soaps but not from toothpaste

PBDE and LEAD

Period of susceptibility

Fertilized egg, embryo fetus, infant, child and teenager

Exposure timing

More potency in early exposures having greater effect on developing organ systems

Dutch Famine

200% increase in coronary heart disease and more obesity in early gestation exposure with decreases later in gestation and later in life

Ubiquity of chemical exposures

Chemical body burden